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Brito L, Bernardo AC, Leite Â, Pereira MG. Portuguese Caregivers of Persons With Alzheimer's Disease in the Context of the COVID-19 Pandemic: A Qualitative Study of the Grieving Process. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241246417. [PMID: 38697016 DOI: 10.1177/00302228241246417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
This study addresses the experiences of informal caregivers caring for elderly family members with Alzheimer's disease (AD) during the COVID-19 pandemic. The study includes a sample of eight informal caregivers who were evaluated through a semi-structured interview six months after the death of a loved one they cared for. A thematic content analysis was applied to the interviews and yielded two higher-order domains: (1) Experiencing the AD and the death of a family member and (2) The grieving process during the COVID-19 pandemic. The results provide valuable insights into family caregivers' experiences regarding the profound emotional impact of caregiving and grief during the COVID-19 pandemic. Caregivers maintain their identity even after loss, underscoring the enduring impact of caregiving. The identity as a caregiver impacted coping and grief responses, highlighting the need for tailored interventions.
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Affiliation(s)
- Laura Brito
- Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Cristina Bernardo
- Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ângela Leite
- Centre for Philosophical and Humanistic Studies, Portuguese Catholic University, Braga, Portugal
| | - M Graça Pereira
- Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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Ozcan M, Akyar I. The effect of structured education and phone follow-up on moderate stage Alzheimer's disease caregiving: Outcomes for patient and caregivers. Jpn J Nurs Sci 2024; 21:e12574. [PMID: 38031663 DOI: 10.1111/jjns.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023]
Abstract
AIM To determine the effectiveness of a caregiver education (needs tailored) and telephone follow-up intervention for caregivers of people with moderate stage Alzheimer's disease on caregiver burden, caregiving impact on life, and patients' neuropsychiatric symptoms, dependence on activities of daily living. METHODS This quasi-experimental study sampled caregivers of people with moderate stage Alzheimer's. Caregivers in the intervention group received education and telephone follow-up over 12 weeks, while the control group received routine care. Caregivers were assessed for burden, changes in life, and patients for neuropsychiatric symptoms, and dependence on daily living activities. RESULTS The caregiver burden, life changes, distress, and patients' neuropsychiatric symptom scores showed apparent trend toward betterment, but no statistically significant differences were found in study outcomes between the two groups (P > .05). CONCLUSION The caregiver need-based, structured education and telephone follow-up intervention was not empirically effective. With the promising effect from this study, managing behavioral symptoms with need-based, structured, and skill-oriented training has the potential to alleviate the burden on caregivers.
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Affiliation(s)
- Munevver Ozcan
- Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Turkey
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Melchior F, Teichmann B. Measuring Dementia Knowledge in German: Validation and Comparison of the Dementia Knowledge Assessment Scale, the Knowledge in Dementia Scale, and the Dementia Knowledge Assessment Tool 2. J Alzheimers Dis 2023:JAD230303. [PMID: 37302037 PMCID: PMC10357161 DOI: 10.3233/jad-230303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Assessing dementia knowledge is critical for developing and improving effective interventions. There are many different tools to assess dementia knowledge, but only one has been validated in German so far. OBJECTIVE To validate two tools for assessing dementia knowledge-the Dementia Knowledge Assessment Scale (DKAS-D) and the Knowledge in Dementia Scale (KIDE-D) for the German general population-and compare their psychometric properties with the Dementia Knowledge Assessment Tool 2 (DKAT2-D). METHODS A convenience sample of 272 participants completed online surveys. Analyses included internal consistency, structural validity, construct validity through the known-groups method, retest-reliability with a subgroup of n = 88, and floor and ceiling effects. This study used the STROBE checklist. RESULTS Internal consistency was acceptable for DKAT2-D (α= 0.780), very good for DKAS-D (α= 0.873), and poor for KIDE-D (α= 0.506). Construct validity was confirmed for all questionnaires. Retest-reliability was good for DKAT2-D (0.886; 0.825-0.926) and KIDE-D (0.813; 0.714-0.878), while it was great for DKAS-D (0.928; 0.891-0.953). Trends toward ceiling effects were observed for DKAT2-D and KIDE-D, but not for DKAS-D. The principal component analysis did not reveal a coherent structure for DKAT2-D or KIDE-D, while the confirmatory factor analysis proposed the removal of 5 items for DKAS-D resulting in the shortened DKAS20-D, which had nearly identical properties. CONCLUSION Both DKAS-D and its shortened version, DKAS20-D, are reliable instruments for evaluating programs intended for the general population, as they were found to be convincing in all aspects.
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Affiliation(s)
- Florian Melchior
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Matsumoto H, Maeda A, Igarashi A, Weller C, Yamamoto-Mitani N. Dementia education and training for the general public: A scoping review. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:154-184. [PMID: 34791985 DOI: 10.1080/02701960.2021.1999938] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The lack of public awareness and understanding of dementia affects the experiences of people living with dementia and their families. Dementia education and training for the general public have been gradually disseminated. We conducted a systematic scoping review guided by PRISMA-ScR to map existing evidence and identify dementia education and training available to the general public. From the four electronic databases, 41 articles were identified. Dementia education has three main purposes: dementia friendliness (n = 25), early diagnosis/help-seeking (n = 10), and prevention (n = 6). Education aimed at dementia friendliness was delivered in the community (n = 6), schools/universities (n =14), workplaces (n = 2), and online (n = 3). Interventions aimed at early diagnosis and prevention were often conducted in communities with middle-aged and older people or specific ethnic groups. Eleven dementia-friendliness studies reported on the interaction with people living with dementia to reduce stigma. Dementia knowledge, attitudes, and preventive behaviors were assessed as outcomes. Though randomized controlled trials were conducted in early diagnosis and prevention studies via e-learning, they were not performed in dementia-friendliness studies. Therefore, there is a need to further accumulate evidence of dementia education for each of these purposes.
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Affiliation(s)
- Hiroshige Matsumoto
- Department of Community Health Nursing, School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akari Maeda
- Department of Community Health Nursing, School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Carolina Weller
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, School of Medicine, The University of Tokyo, Tokyo, Japan
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Mossello E, Baccini M, Caramelli F, Biagini CA, Cester A, De Vreese LP, Darvo G, Vampini C, Gotti M, Fabbo A, Marengoni A, Cavallini MC, Gori G, Chattat R, Marini M, Ceron D, Lanzoni A, Pizziolo P, Mati A, Zilli I, Cantini C, Caleri V, Tonon E, Simoni D, Mecocci P, Ungar A, Masotti G. Italian guidance on Dementia Day Care Centres: A position paper. Aging Clin Exp Res 2023; 35:729-744. [PMID: 36795236 PMCID: PMC9933825 DOI: 10.1007/s40520-023-02356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Dementia Day Care Centres (DDCCs) are defined as services providing care and rehabilitation to people with dementia associated with behavioural and psychological symptoms (BPSD) in a semi-residential setting. According to available evidence, DDCCs may decrease BPSD, depressive symptoms and caregiver burden. The present position paper reports a consensus of Italian experts of different disciplines regarding DDCCs and includes recommendations about architectural features, requirements of personnel, psychosocial interventions, management of psychoactive drug treatment, prevention and care of geriatric syndromes, and support to family caregivers. DDCCs architectural features should follow specific criteria and address specific needs of people with dementia, supporting independence, safety, and comfort. Staffing should be adequate in size and competence and should be able to implement psychosocial interventions, especially focused on BPSD. Individualized care plan should include prevention and treatment of geriatric syndromes, a targeted vaccination plan for infectious diseases including COVID-19, and adjustment of psychotropic drug treatment, all in cooperation with the general practitioner. Informal caregivers should be involved in the focus of intervention, with the aim of reducing assistance burden and promoting the adaptation to the ever-changing relationship with the patient.
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Affiliation(s)
- Enrico Mossello
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy.
| | | | - Francesca Caramelli
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
| | | | | | - Luc Pieter De Vreese
- Department of Mental Health and Addictions, Cognitive Clinic, Azienda USL Modena, Italy
| | - Gianluca Darvo
- Department of Architecture, University of Florence, Florence, Italy
| | - Claudio Vampini
- Psychiatric and Psychogeriatric Service, San Francesco Hospital, Garofalo Health Care, Verona, Italy
| | - Mabel Gotti
- Psychotherapist and Psychoanalyst, Italian Society of Interpersonal Psychoanalysis, Florence, Italy
| | - Andrea Fabbo
- Cognitive Disorders and Dementia Unit, Health Authority and Services of Modena, Modena, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Chiara Cavallini
- Continuity of Care Agency, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Guido Gori
- Scientific Director, PAS Pubbliche Assistenze Foundation, Florence, Italy
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Monica Marini
- Staff Coordinator, Healthcare Executive, Tuscany Region, Italy
| | - Davide Ceron
- Opera Immacolata Concezione Foundation, Padua, Italy
| | - Alessandro Lanzoni
- Cognitive Disorders and Dementia Unit, Primary Care Department, Health District of Modena, Modena, Italy
| | | | | | | | | | | | | | - David Simoni
- Health Area Manager, Arnera Cooperativa Sociale, Pontedera, Italy
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Andrea Ungar
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
| | - Giulio Masotti
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
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O'Connor N, Fox S, Kernohan WG, Drennan J, Guerin S, Murphy A, Timmons S. A scoping review of the evidence for community-based dementia palliative care services and their related service activities. BMC Palliat Care 2022; 21:32. [PMID: 35264118 PMCID: PMC8905782 DOI: 10.1186/s12904-022-00922-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/16/2022] [Indexed: 11/15/2022] Open
Abstract
Background Palliative care is identified internationally as a priority for efficacious dementia care. Research into “effective models” of palliative care for people with dementia has been recommended by several European countries. To build an effective service-delivery model we must gain an understanding of existing models used in similar settings. The study aim is to identify core components of extant models of palliative care for people with dementia, and their families, who are living at home in the community. Methods A scoping review was employed. The search strategy was devised to identify all peer-reviewed research papers relating to the above aim. This process was iterative, and the search strategy was refined as evidence emerged and was reviewed. All types of study designs and both quantitative and qualitative studies of non-pharmacological interventions were considered for inclusion. Results The search identified 2,754 unique citations, of which 18 papers were deemed eligible for inclusion. Although a palliative care approach is recommended from early in the disease process, most evidence involves end-of-life care or advanced dementia and pertains to residential care. The majority of the research reviewed focused on the effects of advance care planning, and end-of-life care; specialist palliative care input, and/or generalist palliative care provided by dementia services to enable people to remain at home and to reduce costs of care. Community staff training in palliative care appeared to improve engagement with Specialist Palliative Care teams. Integration of dementia and palliative care services was found to improve care received for people with dementia and their carers. Conclusions While the evidence for integration of dementia and palliative care services is promising, further high-quality research is necessary particularly to identify the key components of palliative care for people living with dementia. This is imperative to enable people with dementia to inform their own care, to stay living at home for as long as possible, and, where appropriate, to die at home. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00922-7.
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Affiliation(s)
- Niamh O'Connor
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Siobhan Fox
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland. .,Centre for Gerontology and Rehabilitation, The Bungalow, St Finbarr's Hospital, Block 13, Douglas road, T12XH60, Cork, Republic of Ireland.
| | - W George Kernohan
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Aileen Murphy
- Department of Economics, University College Cork, Cork, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
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Crawley S, Moore K, Vickerstaff V, Fisher E, Cooper C, Sampson EL. How do factors of sociodemographic, health literacy and dementia experience influence carers' knowledge of dementia? DEMENTIA 2022; 21:1270-1288. [PMID: 35234067 PMCID: PMC9109238 DOI: 10.1177/14713012221074219] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dementia is a life limiting disease following a progressive trajectory. As carers often become key decision makers, their knowledge of dementia will have health implications for the person living with dementia as well as carer's psychological wellbeing. AIM To explore how sociodemographic factors, health literacy and dementia experience influence family carers knowledge about dementia. METHOD In this cross-sectional, mixed methods study, we interviewed 150 family carers and assessed their dementia knowledge using the Dementia Knowledge Assessment Scale (DKAS). Linear regression analyses were used to examine whether health literacy, previous experiences of dementia, support group attendance and sociodemographic characteristics predicted knowledge. Sixteen carers also completed qualitative interviews which explored unmet information needs. Transcripts and field notes were thematically analysed. RESULTS Most participants were partners (47%) or adult children (48%) and cared for someone with severe (32%) or moderate (43%) dementia. Mean DKAS scores were 34.8/50 (SD = 7.0, range = 17-48) reflecting 8/25 incorrect answers. Backwards elimination regression found greater dementia knowledge was associated with greater health literacy for appraising information (coef 3.48, 95% CI (1.38, 5.58); p = 0.001) and more years of education (coef 0.39, 95% CI (0.12, 0.65); p = 0.004). Although not significant, knowledge was slightly lower in those who attended a support group, and a trend was found between ability to understand health information and knowledge. Only 39% accurately identified dementia as life shortening, indicating notable gaps in knowledge. Four qualitative themes were identified; arm yourself with information, ability to steer through information, other experience of dementia can be helpful and the importance of relationships with health care professionals. CONCLUSIONS In an information age, vast amounts of information are available, but this can bring difficulties. Carers with more years of education and higher health literacy knew more about dementia. Professionals should consider how carers with lower health literacy can be supported through provision of timely, relevant information.
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Affiliation(s)
- Sophie Crawley
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Kirsten Moore
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
| | - Emily Fisher
- Marie Curie Palliative Care Research Department, Division of Psychiatry, 325312UCL, London, UK
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Tzeng HM, Knight G. Could negative behaviors by patients with dementia be positive communication? Seeking ways to understand and interpret their nonverbal communication. Nurs Forum 2021; 57:318-322. [PMID: 34812493 PMCID: PMC9299486 DOI: 10.1111/nuf.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/15/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
In interactions with caregivers, patients with dementia have communication challenges that are common and worrisome to families. Family and professional caregivers find it challenging to “guess” or “interpret” what their patients with dementia are trying to tell them. In this creative controversy article, we discuss how family and professional caregivers can seek to understand and correctly interpret the nonverbal communications of patients with dementia (behaviors, actions, facial expressions, and vocal sounds). Equipping family and professional caregivers with the resources to interpret the nonverbal communications of patients with dementia requires a commitment to in‐service and family education in healthcare facilities. Nurses could play a critical role in raising the awareness among the public about the potential changes and declines in verbal communications of the patients with dementia.
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Affiliation(s)
- Huey-Ming Tzeng
- School of Nursing, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
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Shaw CA, Williams KN, Perkhounkova Y, Hein M, Coleman CK. Effects of a Video-based Intervention on Caregiver Confidence for Managing Dementia Care Challenges: Findings from the FamTechCare Clinical Trial. Clin Gerontol 2020; 43:508-517. [PMID: 32072866 PMCID: PMC7434650 DOI: 10.1080/07317115.2020.1729917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The Supporting Family Caregivers with Technology trial tested the FamTechCare video support intervention against telephone support. Dementia caregivers' video-recorded challenging care encounters and an interdisciplinary team provided tailored feedback. This paper reports on the effects of the intervention on caregiver confidence in managing priority challenges, a secondary outcome of this non-blinded parallel randomized controlled trial. METHODS Caregiver/person living with dementia dyads were randomized to the experimental FamTechCare video support (n = 43) or attention control telephone support (n = 41) groups. Caregivers providing in-home care to a person living with mild or more severe dementia were eligible. Caregivers identified three priority challenges using the Caregiver Target Problems Questionnaire and rated the frequency and severity of each challenge and their confidence managing the challenge at baseline and 3-months. Challenges were classified using the FamTechCare Technology-supported Dementia Care Typology. Effects on confidence were compared between groups using the Wilcoxon rank-sum test and within groups using the Wilcoxon signed-rank test. RESULTS Caregiver priority challenges included managing dementia behaviors, understanding disease expectations, and performing activity of daily living care. Improvements were observed across the three categories in both groups; however, not all changes were statistically significant. No significant differences were identified between groups. CONCLUSION Caregivers in the FamTechCare group reported benefit across all priority challenges including managing dementia behaviors, understanding disease expectations, and performing activity of daily living care. CLINICAL IMPLICATIONS Innovative technology provides new opportunities to support family caregivers in dementia home care. Video-recording can be used to enhance support for family caregivers facing care challenges.
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Affiliation(s)
- Clarissa A Shaw
- College of Nursing, University of Iowa , Iowa City, Iowa, USA
| | | | | | - Maria Hein
- College of Nursing, University of Iowa , Iowa City, Iowa, USA
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Kokorelias KM, Gignac MAM, Naglie G, Rittenberg N, MacKenzie J, D’Souza S, Cameron JI. A grounded theory study to identify caregiving phases and support needs across the Alzheimer’s disease trajectory. Disabil Rehabil 2020; 44:1050-1059. [DOI: 10.1080/09638288.2020.1788655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kristina M. Kokorelias
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Monique A. M. Gignac
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Work and Health, Toronto, Canada
| | - Gary Naglie
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Nira Rittenberg
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jennifer MacKenzie
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Ontario Shores Centre for Mental Health Sciences, Geriatric Transitional Unit, Whitby, Canada
| | - Samantha D’Souza
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jill I. Cameron
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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Abstract
OBJECTIVES Family caregivers of people with dementia can experience loss and grief before death. We hypothesized that modifiable factors indicating preparation for end of life are associated with lower pre-death grief in caregivers. DESIGN Cross-sectional. SETTING Caregivers of people with dementia living at home or in a care home. PARTICIPANTS In total, 150 caregivers, 77% female, mean age 63.0 (SD = 12.1). Participants cared for people with mild (25%), moderate (43%), or severe dementia (32%). MEASUREMENTS Primary outcome: Marwit-Meuser Caregiver Grief Inventory Short Form (MMCGI-SF). We included five factors reflecting preparation for end of life: (1) knowledge of dementia, (2) social support, (3) feeling supported by healthcare providers, (4) formalized end of life documents, and (5) end-of-life discussions with the person with dementia. We used multiple regression to assess associations between pre-death grief and preparation for end of life while controlling for confounders. We repeated this analysis with MMCGI-SF subscales ("personal sacrifice burden"; "heartfelt sadness"; "worry and felt isolation"). RESULTS Only one hypothesized factor (reduced social support) was strongly associated with higher grief intensity along with the confounders of female gender, spouse, or adult child relationship type and reduced relationship closeness. In exploratory analyses of MMCGI-SF subscales, one additional hypothesized factor was statistically significant; higher dementia knowledge was associated with lower "heartfelt sadness." CONCLUSION We found limited support for our hypothesis. Future research may benefit from exploring strategies for enhancing caregivers' social support and networks as well as the effectiveness of educational interventions about the progression of dementia (ClinicalTrials.gov ID: NCT03332979).
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Resciniti NV, Tang W, Tabassum M, Pearson JL, Spencer SM, Lohman MC, Ehlers DK, Al-Hasan D, Miller MC, Teixeira A, Friedman DB. Knowledge evaluation instruments for dementia caregiver education programs: A scoping review. Geriatr Gerontol Int 2020; 20:397-413. [PMID: 32133754 PMCID: PMC7748382 DOI: 10.1111/ggi.13901] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/19/2019] [Accepted: 02/12/2020] [Indexed: 01/28/2023]
Abstract
With the increase in our older adult population, there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study is to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL and Web of Science with tailored database search terms. The search yielded 8101 results, with 35 studies meeting inclusion. Studies were conducted in eight countries, had varying study designs (randomized controlled trials [RCTs] = 9, non-RCTs = 6, one-group study design = 20) and utilized previously published (19) and author developed (16) instruments. Furthermore, the studies were internationally diverse, conducted in the United States (n = 18), Australia (n = 7), UK (n = 3), China (n = 2), Canada (n = 2), Taiwan (n = 1), Brazil (n = 1) and multi-country (n = 1). Only two studies focused on minority populations. While author-developed instruments may be more relevant and timesaving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and understand better the effects of educational programs on caregiver knowledge. Geriatr Gerontol Int 2020; 20: 397-413.
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Affiliation(s)
- Nicholas V Resciniti
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Weizhou Tang
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Masroora Tabassum
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Joseph Lee Pearson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Sharon Melinda Spencer
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Matthew C Lohman
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Diane K Ehlers
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska
| | - Dana Al-Hasan
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Maggi C Miller
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Ana Teixeira
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Daniela B Friedman
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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13
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Guisado-Fernandez E, Caulfield B, Silva PA, Mackey L, Singleton D, Leahy D, Dossot S, Power D, O'Shea D, Blake C. Development of a Caregivers' Support Platform (Connected Health Sustaining Home Stay in Dementia): Protocol for a Longitudinal Observational Mixed Methods Study. JMIR Res Protoc 2019; 8:13280. [PMID: 31464187 PMCID: PMC6786855 DOI: 10.2196/13280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/23/2022] Open
Abstract
Background Dementia disease is a chronic condition that leads a person with dementia (PwD) into a state of progressive deterioration and a greater dependence in performing their activities of daily living (ADL). It is believed nowadays that PwDs and their informal caregivers can have a better life when provided with the appropriate services and support. Connected Health (CH) is a new technology-enabled model of chronic care delivery where the stakeholders are connected through a health portal, ensuring continuity and efficient flow of information. CH has demonstrated promising results regarding supporting informal home care and Aging in Place, and it has been increasingly considered by researchers and health care providers as a method for dementia home care management. Objective This study aims to describe the development and implementation protocol of a CH platform system to support informal caregivers of PwDs at home. Methods This is a longitudinal observational mixed methods study where quantitative and qualitative data will be combined for determining the utility of the CH platform for dementia home care. Dyads, consisting of a PwD and their informal caregiver living in the community, will be divided into 2 groups: the intervention group, which will receive the CH technology package at home, and the usual care group, which will not have any CH technology at all. Dyads will be followed up for 12 months during which they will continue with their traditional care plan, but in addition, the intervention group will receive the CH package for their use at home during 6 months (months 3 to 9 of the yearly follow-up). Further comprehensive assessments related to the caregiver’s and PwD’s emotional and physical well-being will be performed at the initial assessment and at 3, 6, 9, and 12 months using international and standardized validated questionnaires and semistructured individual interviews. Results This 3-year funded study (2016-2019) is currently in its implementation phase and is expected to finish by December 2019. We believe that CH can potentially change the PwD current care model, facilitating a proactive and preventive model, utilizing self-management–based strategies, and enhancing caregivers’ involvement in the management of health care at home for PwDs. Conclusions We foresee that our CH platform will provide knowledge and promote autonomy for the caregivers, which may empower them into greater control of the care for PwDs, and with it, improve the quality of life and well-being for the person they are caring for and for themselves through a physical and cognitive decline predictive model. We also believe that facilitating information sharing between all the PwDs’ care stakeholders may enable a stronger relationship between them, facilitate a more coordinated care plan, and increase the feelings of empowerment in the informal caregivers. International Registered Report Identifier (IRRID) DERR1-10.2196/13280
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Affiliation(s)
- Estefania Guisado-Fernandez
- Insight Centre for Data Analytics, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- Insight Centre for Data Analytics, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Laura Mackey
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - David Singleton
- Applied Research for Connected Health, University College Dublin, Dublin, Ireland
| | - Daniel Leahy
- Applied Research for Connected Health, University College Dublin, Dublin, Ireland
| | - Sébastien Dossot
- Applied Research for Connected Health, University College Dublin, Dublin, Ireland
| | - Dermot Power
- Medicine for the Older Person, Mater University Hospital, Dublin, Ireland
| | - Diarmuid O'Shea
- Department of Geriatric Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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